Anterior chamber lens implantation in vitrectomised eyes

Abstract

PurposeTo investigate long-term visual acuity (VA) outcomes and complication rates in vitrectomised eyes undergoing anterior chamber intraocular lens (ACIOL) insertion.Patients and methodsA single-centre, retrospective case series including all patients who had undergone ACIOL placement at the time of vitrectomy surgery or having had previous vitrectomy, between January 2007 and January 2013. Patients were identified using an electronic database and paper casefile notes were analysed for all patients. Patients were excluded if they had <3 months follow-up.ResultsTwo hundred and seventy-one patients were included in the analysis. Mean follow-up was 27 months. One hundred and forty-eight patients were vitrectomised before ACIOL placement. One hundred and twenty-three patients underwent vitrectomy at the time of ACIOL placement. Mean best-corrected visual acuity (BCVA) before ACIOL placement was 1.27 LogMar (SD 0.95). Mean BCVA at final follow-up was 0.51 LogMar (SD 0.66) (paired-sample T-test P<0.001). Forty (15%) patients developed postoperative cystoid macular oedema (CMO). Eighty-seven (32%) patients had an intraocular pressure (IOP) rise acutely post ACIOL insertion. Fifteen (6%) patients developed corneal decompensation. Five subsequently required corneal grafting. Sixteen patients had ACIOL displacement or instability requiring further surgery.ConclusionsACIOL insertion after vitrectomy is effective. Ninety-two per cent of patients maintained or gained VA, comparable to previous studies of ACIOL insertion post complicated cataract surgery. Raised IOP was the most frequent complication: 61 patients were on topical therapy at most recent follow-up. CMO tended to be acute. Corneal decompensation was infrequent.

Outcome of Four Point Fixated Open Loop Polymethyl Methacrylate Anterior Chamber Intraocular Lens: A Ten-Year Retrospective Study

“…This is similar to earlier studies. [11,13,14] The refractive outcome in our study is also signi cant. Mean nal spherical equivalent was − 0.41 ± 1.05 D, which was comparable with other studies.…”

“…A unique feature of our study, compared to other studies, is that none of the subjects underwent pars plana vitrectomy before ACIOL implantation, which itself is a technically demanding procedure. [11,12] Being a training institute, our surgeons comprised of both consultants and trainees. If the case was complicated, senior trainees or consultants took over.…”

Double decentred lenses in an eye: a therapeutic dilemma in Marfan syndrome

“…On the other hand, the anterior chamber intraocular lens requires much stability extension from its haptics, which is supported by the angle of the anterior chamber. The optimum diameter of an anterior chamber intraocular lens is thought to be 0.5–1.0 mm greater than the horizontal white‐to‐white corneal diameter measurement 2018. Patients with Marfan syndrome usually have an innately deep and large anterior chamber, and physicians should be alert to the possibility of anterior chamber intraocular lens instability in these patients.…”

<p>Intraocular Lens Implantation In The Ciliary Sulcus: Challenges And Risks</p>

“…If there is no capsule support, iris fixation, scleral fixation, or an anterior chamber intraocular lens (ACIOL) can be used, although the latter should be avoided in patients with shallow anterior chamber and compromised corneas 10. For patients who have undergone pars plana vitrectomy and have no capsule support, scleral fixation, ACIOL, and iris-fixated Artisan-Ophtec aphakic IOL are options, but iris fixation should be avoided due to iridodinesis postvitrectomy 10,11 …”

“…The exact adjustment of IOL power can be calculated if the sulcus position is known but the “rule of 9s” method is a reasonable approximation (Table 1). 10,11…”